1. GENITOURINARY TRAUMA

2. kidney Mechanisms of Injury 1.Blunt renal trauma accidents, falls, crush 2.Penetrating trauma gunshot, stab

3. kidney Classification of Injury 1.Simple laceration 2.Subcapsular hematoma 3.Renal contusion 4.Renal rupture 5.Laceration of renal artery and vein 6.Perirenal hematoma 7.Laceration through collecting system

4. Classification of Injury

5. kidney Diagnosis 1.History 2.Presentation Shock, hematuria, pain 3.Physical examination Mass

6. kidney Diagnosis 4.Urinalysis gross hematuria,microscopic hematuria The degree of hematuria may not predict the severity of renal injury. 5.X-ray examination KUB Intravenous pyelogram (IVU) Arteriography

7. kidney Diagnosis 6. Computed tomography(CT) 7. Ultrasonography 8. Radionuclide scans

8. kidney Treatment 1.Observation Blood pressure,pulse,breathe,urine, hemachrome keep the bed 3-4 weeks

9. kidney Treatment 2. Renal exploration Indication: Uncontrolled bleeding Renovascular injury Nonviable parenchyma Major urinary extravasation

10. Ureter Causes 1. Injury 2. Surgery 3. Endoscopy 4. Radiolgy therapy

11. Ureter Presentation: 1. History 2. Urine leak 3. Infection 4. Aurina 5. Hematuria 6. Obstruction

12. Ureter Diagnosis 1. History 2. Intravenous pyelogram (IVU) 3. Retrograde pyelogram

13. Ureter Treatment 1. One-stage repair during the initial evaluation of a trauma 2. External drainage for 3 months if injury above 24h.

14. Bladder Classification and Mechanism of Injury 1.Causes Blunt trauma, penetrating trauma Endoscopy 2.Site Extraperitoneal Rupture Intrapritoneal Rupture Combined Rupture

15. Site of bladder injure

16. Bladder Diagnosis 1. History 2. Catheterization examination 3. Cystography

17. Bladder Treatment 1. Intrapritoneal Rupture Surgical exploration and repair 2. Extraperitoneal Rupture Surgical exploration and repair or Catheterization 3. Anti-infection

18. Urethra Causes 1. Endo-urethra injury endosocopy 2. Exterior-urethra injury pelvis-fracture

19. Urethra Site 1. Posterior urethra prostatic and membranous injuries above or including the urogenital diaphragm 2. Anterior urethra injuries of the bulbous and penile urethra

20. Anatomise of urethra

21. Injury of anterior urethra

22. Injury of posterior urethra

23. Urethra Pathology 1. Sprian 2. Cracking 3. Rupture Stage: 1. Trauma period 2. Inflammation period 3. Structure period

24. Urethra Presentation 1. Shock 2. Bleeding 3. Pain 4. Void unsuccessful and Rentention 5. Haematoma 6. Urine leak

25. Urethra Diagnosis 1. History 2. Physical examination digital rectal examination 3. Catheter insert 4. Retrograde urethrography

26. Urethra Treatment 1. Anti-infection and prevent shock 2. Main urethral successive 3. Drainage urine of bladder 4. Drainage urine leak

27. Thank you!